Active NPI
Jonathan Edward Jensen, M.D.
- Gastroenterology Physician
- Kingsport, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 69824
- Practice address
- 130 W Ravine Rd
Kingsport, TN 37660-3837 - Phone
- (423) 224-4000
- NPI assigned
- Jan 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | 33738 | CO | |
| Gastroenterology Physician | 207RG0100X | 042-0014522 | VT | |
| Gastroenterology Physician | 207RG0100X | 69824 | TN | Primary |
Addresses
Primary practice location
130 W Ravine Rd
Kingsport, TN 37660-3837
Mailing address
1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565
Other practice location 1
205 S Main St
Suite a
Longmont, CO 80501-1716
Phone (303) 776-6115
Other practice location 2
111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000
Other practice location 3
100 Hospital Ln Ste 100
Danville, IN 46122-1993
Phone (317) 745-7310
Other practice location 4
1 Medical Park Blvd
Bristol, TN 37620-7430
Phone (423) 844-1121
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | direct@direct.bronsonhg.org | Direct | Bronson Healthcare Group |
| Direct Messaging Address | jjensen344535@direct-PRD.stelizabeth.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT, SC, MT, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1401 E State St
Rockford, IL 61104-2315
Phone (815) 489-4400
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 26 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 77 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 042-0014522 | VT | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swedishamerican Hospital | Current | Accepting new patients | |
| Swedishamerican Hospital | Current | Accepting new patients | |
| RCHP Billings - Missoula LLC | Current | Accepting new patients | |
| University of Vermont Medical Center Inc | Current | Accepting new patients | |
| RCHP Billings - Missoula LLC | Current | Accepting new patients | |
| Swedishamerican Hospital | Current | Accepting new patients | |
| Prisma Health Medical Group-Midlands | Current | Accepting new patients | |
| Prisma Health Medical Group-Midlands | Current | Accepting new patients |
Locations
1401 E State St
Rockford, IL 61104
Phone (815) 489-4267
6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610
2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285
2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202
2230 N Reserve St
Missoula, MT 59808
Phone (406) 721-0533
2230 N Reserve St
Ste 402
Missoula, MT 59808
Phone (406) 327-3850
3 Richland Medical Park Dr
Ste 120
Columbia, SC 29203
Phone (803) 434-8866
2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930
111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415
1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531
Interoperability endpoints
- jjensen344535@direct-prd.stelizabeth.com
- jjensen3947729@direct.trinity-health.org
Organizations & group practices 8
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Rockford, IL
- NPI 1962451732
-
- Multi-Specialty Clinic/Center
- Columbia, SC
- NPI 1275988321
-
- Specialist
- Missoula, MT
- NPI 1376946913
-
- Internal Medicine Physician
- Burlington, VT
- NPI 1659309615
-
- Durable Medical Equipment & Medical Supplies
- Columbia, SC
- NPI 1881469856
-
- Medical Oncology Physician
- Missoula, MT
- NPI 1891164125
-
- Community/Retail Pharmacy
- Rockford, IL
- NPI 1306635982
-
- General Acute Care Hospital
- Rockford, IL
- NPI 1760542732
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Rockford, IL
- NPI 1760542732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714089600000",
"number": "1598745002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 W OAKLAND AVE STE 310",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042192",
"telephone_number": "423-302-6565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 W RAVINE RD",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376603837",
"telephone_number": "423-224-4000"
}
],
"practiceLocations": [
{
"address_1": "205 S Main St",
"address_2": "SUITE A",
"address_purpose": "LOCATION",
"city": "Longmont",
"state": "CO",
"postal_code": "805011716",
"country_code": "US",
"telephone_number": "303-776-6115",
"fax_number": "303-776-4318",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "111 Colchester Ave",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "VT",
"postal_code": "054011473",
"country_code": "US",
"telephone_number": "802-847-0000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 Hospital Ln Ste 100",
"address_purpose": "LOCATION",
"city": "Danville",
"state": "IN",
"postal_code": "461221993",
"country_code": "US",
"telephone_number": "317-745-7310",
"fax_number": "317-745-7320",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Medical Park Blvd",
"address_purpose": "LOCATION",
"city": "Bristol",
"state": "TN",
"postal_code": "376207430",
"country_code": "US",
"telephone_number": "423-844-1121",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JENSEN",
"first_name": "JONATHAN",
"middle_name": "EDWARD",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-19",
"last_updated": "2024-04-26",
"certification_date": "2024-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CO",
"license": "33738",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "VT",
"license": "042-0014522",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "TN",
"license": "69824",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "direct@direct.bronsonhg.org",
"affiliation": "Y",
"endpointDescription": "Bronson Healthcare Group Direct address",
"affiliationName": "Bronson Healthcare Group",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Continuity of Care Document",
"address_1": "601 John St",
"city": "Kalamazoo",
"state": "MI",
"country_code": "US",
"postal_code": "490075341",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jjensen344535@direct-PRD.stelizabeth.com",
"affiliation": "N",
"address_1": "100 Hospital Ln Ste 100",
"city": "Danville",
"state": "IN",
"country_code": "US",
"postal_code": "461221993",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.